Online Banking - Business

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Company Information - Primary Signer

Company Name

OKCompany Name is required

Address

OKAddress is required

City

OKCity is required

State

OKState is required

Zip

OKZip is required

Taxpayer ID

OKTaxpayer ID is required

Primary Signer Name

OKPrimary Signer Name is required

Title

OKTitle is required

Phone

--

OKPhone is required

Email

OKEmail is required

On-Line Cash Management (individual fees apply)

In addition to Account Access (viewing account balances, transferring funds between accounts and other common banking functions) please select any of the following additional services you wish to utilize:

On-Line Bill Pay

On-Line Wire Transfer

On-Line Banking with Quicken/Money

On-Line Banking with QuickBooks

On-Line ACH Origination

On-Line Tax Payments

On-Line Positive Pay

OptionalOK is required

Account Information

Please identify all of your Merchants National Bank account(s) that you wish to access through Merchants On-Line Banking

Account Number

Account Type

1

OK1 is required

OK is required

2

OptionalOK2 is required

OK is required

3

OptionalOK3 is required

OK is required

4

OptionalOK4 is required

OK is required

5

OptionalOK5 is required

OK is required

6

OptionalOK6 is required

OK is required

Security Code

OK is required

Merchants National Bank reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, you grant full permission to do so.